十四味通络热奄包预防PICC术后静脉血栓的护理研究  

Effect of TMC Shisiwei Tongluo hot package in prevention of venous thrombosis after PICC operation

作　　者：向效麒 代丽娜 杨明仙 陈西 何蔚楹[4] XIANG Xiaoqi;DAI Lina;YANG Mingxian;CHEN Xi;HE Weiying(Department of Rehabilitation,Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650021,Yunnan,China;Department of Tumor&Pain,Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650021,Yunnan,China;The Second Ward of Geriatrics Department,Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650021,Yunnan,China;Operating Room,Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650021,Yunnan,China)

机构地区：[1]云南省中医医院康复科,云南昆明650021 [2]云南省中医医院肿瘤疼痛科,云南昆明650021 [3]云南省中医医院老年病科二病区,云南昆明650021 [4]云南省中医医院手术室,云南昆明650021

出　　处：《右江医学》2023年第2期133-137,共5页Chinese Youjiang Medical Journal

基　　金：云南中医药大学-云南中医药大学第一附属医院联合基金项目(XYLH202014)。

摘　　要：目的研究十四味通络热奄包预防外周穿刺置入中心静脉导管(PICC)术后静脉血栓的效果。方法选取PICC术后患者120例,随机分为对照组和观察组,每组60例。对照组在PICC置管后采取常规护理方案,并给予热水袋热敷,观察组在PICC置管后采取常规护理联合热奄包外敷。观察两组患者PICC术后疼痛缓解情况,分别于PICC置入前1天及置入后30天对患者空腹凝血指标进行检测,并行上肢静脉超声,判断是否存在上肢静脉血栓(UEVT),再根据患者情况对UEVT进行分级,同时记录置管侧的腋静脉最大血流速度。结果观察组患者在PICC术后第2、3、4天的疼痛评估均显著优于对照组(P<0.001);置管后30天,观察组D-二聚体低于对照组(P<0.05),置管侧腋静脉血流速度大于对照组(P<0.001);对照组UEVT发生率为13.33%,观察组仅为1.67%,观察组UEVT发生率低于对照组(P<0.05)。结论十四味通络热奄包具有清热解毒、活血化瘀等作用,对PICC置管局部热敷可促进血液循环,减轻疼痛,持续使用可预防UEVT的发生。Objective To study the effect of TMC Shisiwei Tongluo hot package in the prevention of venous thrombosis after the operation of peripherally inserted central catheter(PICC).Methods 120 patients with PICC operation were selected and randomly divided into control group and study group,with 60 cases in each group.After PICC intubation,the control group were given routine nursing and fomentation of hot water bag,and the study group were given routine nursing combined with external application of TMC Shisiwei Tongluo hot package.The pain relief after PICC in the two groups was observed,and fasting coagulation indexes were detected 1 day before and 30 days after PICC placement.The ultrasound was performed on upper limbs vein to determine whether there was upper extremity venous thrombosis(UEVT),which was then graded according to patient's condition,and the maximum blood flow velocity of the axillary vein on the catheter side was recorded.Results The pain assessment of patients in the study group on the 2nd,3rd,and 4th day after PICC was significantly better than that in the control group(P<0.05).30 days after PICC placement,the level of D-dimer in the study group was lower than that in the control group(P<0.05),and the blood flow velocity of the axillary vein on the side of the catheter was faster than that in the control group(P<0.01).The incidence of UEVT in the study group(1.67%)was lower than that in the control group(13.33%)(P<0.05).Conclusion TMC Shisiwei Tongluo hot package has the functions of heat-clearing,detoxifying,promoting blood circulation and removing blood stasis,and its local application after PICC placement can promote blood circulation and relieve pain,and the continuous use can prevent the occurrence of UEVT.

关 键 词：热奄包 PICC术后 上肢静脉血栓 

分 类 号：R364.15[医药卫生—病理学]